A male patient in their early 50s with no history of prior known diseases was admitted to the hepatobiliary surgery unit with epigastric pain and jaundice of 2 weeks. Electrocardiogram (ECG) findings at admission were normal. On the third day of admission, the patient experienced a sudden squeezing pain in the anterior chest at rest, with a heart rate of 44 beats/min, blood pressure of 97/60 mm Hg, and oxygen saturation of 98%. The ECG (Figure, A) showed troponin I level of 0.107 ng/mL (normal reference value, 0 to approximately 0.034 ng/mL; to convert to micrograms per liter, multiply by 1). Isoproterenol was immediately administered by intravenous infusion due to a significantly decreased heart rate. About 20 minutes later, the patient reported that the pain was relieved, and a repeat ECG was done (Figure, B).
Please finish quiz first before checking answer.
Read the answer below and download your certificate.
Read the discussion below and retake the quiz.
Sign in to take quiz and track your certificates
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Yi Tang, PhD, Department of Cardiology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Clinical Medicine Research Center of Heart Failure of Hunan Province, Hunan Normal University, Changsha 410005, China (firstname.lastname@example.org).
Published Online: November 20, 2023. doi:10.1001/jamainternmed.2023.4841
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank Xiaohui Duan, PhD, from Hunan Provincial People’s Hospital for providing part data of the patient; compensation was not received.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
You currently have no searches saved.
You currently have no courses saved.